Jens Bucksch

Secular trends in moderate-to-vigorous physical activity in 32 countries from 2002 to 2010: a cross-national perspective

BACKGROUND Sufficient levels of moderate to vigorous physical activity (MVPA) give substantial health benefits to adolescents. This article examines trends in physical activity (PA) from 2002 to 2010 across 32 countries from Europe and North America. METHODS Representative samples included 479 674 pupils (49% boys) aged 11 years (n = 156 383), 13 years (n = 163 729) and 15 years (n = 159 562). The trends in meeting the recommendations for PA (at least 60 min daily) were evaluated using logistic regression. RESULTS There was a slight overall increase between 2002 and 2010 (17.0% and 18.6%, respectively). MVPA increased significantly (P ≤ 0.05) among boys in 16 countries. Conversely, nine countries showed a significant decrease. Among girls, 10 countries showed a significant increase (P ≤ 0.05). Eight countries showed a significant decrease. For all countries combined, girls were slightly less likely to show an increase in PA over time. CONCLUSIONS The majority of adolescents do not meet current recommendations of PA. Further investment at national and international levels is therefore necessary to increase PA participation among children and adolescents and reduce the future health burden associated with inactivity.

Physical activity of moderate intensity in leisure time and the risk of all cause mortality

Background: There are conflicting data about the health benefits of moderately intense physical activity. Objectives: To examine the effect of such activity on all cause mortality in a German sample of men and women. Methods: Physical activity during leisure time of 3742 men and 3445 women aged 30 to 69 was assessed in a baseline questionnaire from 1984 to 1986. The participants were observed during the follow up period until 1998 when a mortality follow up was conducted. Results: During the follow up period, 300 women and 643 men had died. The multivariate rate ratios (RR) for the volume of lifestyle activities of moderate intensity (for example, gardening, walking, cycling) compared with sedentary lifestyle showed a clearly protective dose–response relation (p for trend <0.001) in women but not in men (p for trend 0.20). Following the recommendation for health enhancing physical activity a second analysis was conducted; 2.5 hours per week taking part in physical activity of moderate intensity decreased the relative risk of overall mortality (0.65 (95% confidence interval, 0.51 to 0.82) and 0.90 (0.77 to 1.01) for women and men, respectively). Conclusions: The volume of lifestyle activities of moderate intensity in leisure time was inversely associated with all cause mortality in women but not in men. With regard to the health enhancing physical activity recommendation as a threshold, there were favourable findings only in women.

Age, puberty, body dissatisfaction, and physical activity decline in adolescents. Results of the German Health Interview and Examination Survey (KiGGS).

BackgroundPhysical activity (PA) shows a marked decline during adolescence. Some studies have pointed to pubertal status or timing as possible PA determinants in this age group. Furthermore, it was supposed that the impact of pubertal changes on PA might be mediated by psychological variables like body dissatisfaction (BDS).MethodsThe 11- to 17-year-old subsample of the German Health Interview and Examination Survey (KiGGS) was used (n = 6 813; 51.3% male, response rate = 66.6%). Through sex-specific sequential multinomial logistic regressions we analysed the univariate and independent associations of chronological age, absolute pubertal status, relative pubertal timing, and BDS with the frequency of PA.ResultsChronological age showed a significantly negative association with PA in both sexes, independent of puberty. The odds of inactivity in contrast to nearly daily PA increased about 70% in boys and 35% in girls for each year of age, respectively. Adjusted for age and other possible confounders, inactivity was significantly less likely for boys in late pubertal stages (OR = 0.27, 95% CI = 0.09-0.78). The risk of inactivity was more than doubled in boys maturing earlier than peers in terms of relative pubertal timing (OR = 2.20, 95% CI = 1.36-3.56). No clear significant puberty effects were found in girls, but the inactivity was more likely for those with irregular menstruation (OR = 1.71, 95% CI = 1.06-2.75). BDS also contributed to the prediction of PA in both sexes. It partially mediated puberty effects in boys but not in girls.ConclusionsOverall, chronological age was a far more important predictor of PA in German adolescents than absolute pubertal status or relative pubertal timing. Further possible explanatory variables like sociocultural influences, social support or increasing time requirements for education should be analysed in conjunction with chronological age in future studies.

Sitting time in Germany: an analysis of socio-demographic and environmental correlates

BackgroundSedentary behaviour in general and sitting time in particular is an emerging global health concern. The aim of this study was to provide data on the prevalence of sitting time in German adults and to examine socio-demographic and environmental correlates of sitting time.MethodsA representative sample of German adults (n = 2000; 967 men, 1033 women; 49.3 ±17.6 years of age) filled in the Global Physical Activity Questionnaire, including one question on overall sitting time and answered questions about the neighbourhood environment, as well as concerning demographics. Daily sitting time was stratified by gender, age group, BMI, educational and income level, as well as physical activity (PA). To identify socio-demographic and environmental correlates of sitting time, we used a series of linear regressions.ResultsThe overall median was 5 hours (299 minutes) of sitting time/day and men sat longer than women (5 vs. 4 hours/day; p < 0.05). In both genders age and PA were negatively and the educational level positively associated with sitting time. The level of income was not a correlate of sitting time in multivariate analyses. Sitting time was significantly positively associated with higher neighbourhood safety for women. The variance of the multivariate model ranged from 16.5% for men to 8.9% for women.ConclusionsThe overall sitting time was unequally distributed in the German adult population. Our findings suggest implementing specific interventions to reduce sitting time for subgroups such as men, younger aged adults and adults with a higher education and lower PA. Future studies should enhance our understanding of the specific correlates of different types and domains of sitting in order to guide the development of effective public health strategies.

Physical activity and screen-based media use: cross-sectional associations with health-related quality of life and the role of body satisfaction in a representative sample of German adolescents

Purpose: Although it is widely accepted that physical activity (PA) positively, and screen-based media use (SBM) negatively, affects well-being, there is a lack of studies relating PA and SBM to health-related quality of life (HRQoL) in adolescents. We examined these associations in German adolescents for different HRQoL subdomains and explored the role of body satisfaction as a possible mediator. Methods: The 11–17-year-old subsample of the German Health Interview and Examination Survey (2003–2006) was analysed (N = 6813; 51.3% male). Cross-sectional associations of self-reported PA frequency and amount of daily SBM with HRQoL subscale scores (according to KINDL-R) were examined by hierarchical linear regression models, adjusting for the clustering of the sample and for a variety of possible confounders. The size and significance of indirect effects via body (dis)satisfaction (BDS) were examined by mediation analyses. Results: Higher PA frequency was significantly associated with higher HRQoL on nearly all subscales and dose–response-relationships were observable. Variations were greatest in terms of social well-being in boys (effect size d = 0.59) and physical well-being in girls (d = 0.43). Higher SBM was related to lower HRQoL on all subscales in girls and on some subscales in boys, with the largest effects for school functioning in both genders (d = 0.31 and 0.37, respectively). The mediated effects for PA and SBM were significant in both genders, but the sizes and the proportions of total effects mediated by body satisfaction were rather small. Conclusions: Higher PA frequency was associated with higher self-reported HRQoL, and higher SBM was associated with lower self-reported HRQoL in both genders, even after adjusting for relevant covariates. The results support the assumption of independent health impacts of both behaviours, although no causal relationship can be confirmed with these cross-sectional data. Mechanisms other than body satisfaction must largely account for the effects of PA and SBM on well-being.

The association between physical activity and perceived environment in German adults

BACKGROUND There is a growing body of international data on the association between physical activity (PA) and variables of the perceived environment. German data is still lacking. The purpose of this study was to provide data on PA (moderate-to-vigorous PA (MVPA) vs. walking) and the perceived environment in urban and rural areas. METHODS We conducted a cross-sectional survey with inhabitants of urban (n = 310) and rural (n = 345) areas in the western part of Germany. The sample consisted of 655 adults [49.8% women; mean age = 43.3 (SD = 12.7)]. The International Physical Activity Questionnaire (IPAQ)-short version and the IPAQ environmental module were used. Outcome variables were time in MVPA as well as in walking. We analysed the association between perceived environmental variables and PA by a series of linear regressions. RESULTS We observed associations between PA and access to destinations, well-maintained sidewalks, seeing physically active people in the neighbourhood, higher residential density and neighbourhood safety. The associations varied as a function of PA (MVPA vs. walking) and area (urban vs. rural). The variance explaining the models including environmental variables as well as sex and age ranged from 1% (model: MVPA in rural area) up to 9.9% (model MVPA in urban area). CONCLUSIONS Our findings suggest that the perceived environment is important to promote both MVPA and walking in rural and urban areas. To better understand environmental correlates in rural structures, we particularly need more specific studies.

Systematic review on measurement properties of questionnaires assessing the neighbourhood environment in the context of youth physical activity behaviour

BackgroundHigh-quality measurement instruments for assessing the neighbourhood environment are a prerequisite for identifying associations between the neighbourhood environment and a person’s physical activity. The aim of this systematic review was to identify reliable and valid questionnaires assessing neighbourhood environmental attributes in the context of physical activity behaviours in children and adolescents. In addition, current gaps and best practice models in instrumentation and their evaluation are discussed.MethodsWe conducted a systematic literature search using six databases (Web of Science, Medline, TRID, SportDISCUS, PsycARTICLES and PsycINFO). Two independent reviewers screened the identified English-language peer-reviewed journal articles. Only studies examining the measurement properties of self- or proxy-report questionnaires on any aspects of the neighbourhood environment in children and adolescents aged 3 to 18 years were included. The methodological quality of the included studies was assessed using the COSMIN checklists.ResultsWe identified 13 questionnaires on attributes of the neighbourhood environment. Most of these studies were conducted in the United States (n = 7). Eight studies evaluated self-report measures, two studies evaluated parent-report measures and three studies included both administration types. While eight studies had poor methodological quality, we identified three questionnaires with substantial test-retest reliability and two questionnaires with acceptable convergent validity based on sufficient evidential basis.ConclusionsBased on the results of this review, we recommend that cross-culturally adapted questionnaires should be used and that existing questionnaires should be evaluated especially in diverse samples and in countries other than the United States. Further, high-quality studies on measurement properties should be promoted and measurement models (formative vs. reflexive) should be specified to ensure that appropriate methods for psychometric testing are applied in future studies.

Recommendations for Promoting Physical Activity for Children and Adolescents in Germany. A Consensus Statement

Increasing physical activity and reduction of sedentary behaviour play important roles in health promotion and prevention of lifestyle-related diseases in children and adolescents. However, the question of how much physical activity is useful for which target group is still a matter of debate. International guidelines (World Health Organization; European Association for the Study of Obesity), which are mainly based on expert opinions, recommend 60 min of physical activity every day. Age- and sex-specific features and regional differences are not taken into account. Therefore, expert consensus recommendations for promoting physical activity of children and adolescents in Germany were developed with special respect to national data, but also with respect to aspects of specific target groups, e.g., children with a lower socio-economic status (SES) or with migration background. They propose 90 min/day of physical activity, or at least 12,000 steps daily. Additionally, lifestyle factors, especially restriction of media consumption, were integrated. The recommendations provide orientation for parents and caregivers, for institutions such as schools and kindergartens as well as for communities and stakeholders.

Individual and school level correlates of moderate to vigorous physical activity among school-children in Germany - a multi-level analysis

BackgroundYoung people spend half of their days in school, but evidence concerning the influence of school environment on the physical activity (PA) of pupils is still inconsistent. A better understanding of potential correlates of PA on the school-level and their possible interaction with individual aspects is needed to improve the development of more effective interventions.MethodsWe used data from the 2009/10 German Health Behaviour in School-aged Children study (HBSC)-sample (n=5,005 students aged 11–15 years) including self-reported moderate to vigorous intensity PA as well as a variety of biological, demographic and behavioral correlates and matched them with school-level data from the national school principals’ HBSC questionnaire. We analyzed the associations of individual- and school-level correlates with MVPA by gender-specific multi-level regression.ResultsOnly a small share of the overall variation in student’s PA was attributable to the school-level. Consequently, the associations of individual-level correlates with PA were stronger than those of the school-level. Our analysis revealed significant associations of individual-level (i.e. age, consumption of softdrinks, overweight) as well as school-level correlates (i.e. the availability of a football ground and a swimming pool) with MVPA. We also observed some gender-specific findings especially for the school level correlates. Cross-level interactions between individual- and school-level were not apparent.ConclusionsOur findings indicate the usefulness of applying an ecological framework to understand and explain complex health behaviors like PA. As we found gender-specific association it might be important to acknowledge that boys and girls have specific needs to be more physically active. Further research should also take other features/elements of the school environment and neighborhood as well as socio-cognitive correlates into account to advance the field.

The transtheoretical model in the context of physical activity in a school-based sample of German adolescents.

Abstract Physical activity in adolescents is an important public health issue. Regular participation in physical activity is associated with various health benefits. However, problems with motivational adherence to physical activity have been documented. The transtheoretical model is a model of behaviour change. This model, which consists of stages of change, self-efficacy, decisional balance, and processes of change, has not been extensively investigated in youth. In addition, the health-enhancing physical activity concept has rarely been applied in this context. A cross-sectional design was used. A random sample of seven junior high schools from Bremen (Germany) resulted in a sample of 588 adolescents (50.5% males, mean age=15.0 years, s=0.67). Respondents completed a self-administered questionnaire assessing stages of change, self-efficacy, decisional balance, and processes of change. Univariate analyses of variance were used to identify which constructs differed significantly across the stages of change. Discriminant analysis was used to determine which variables best discriminate the stages. Distribution of the sample across the stages was: precontemplation, n=175 (29.8%); contemplation, n=135 (22.0%); preparation, n=63 (10.7%); action, n=20 (3.4%); and maintenance, n=195 (33.2%). Significant effects of stages of change were found for self-efficacy, pros, and seven of the ten processes of change. In general, scores of these constructs increased across the stages. Cons did not differ significantly across the stages. The results provide support for some of the assumptions of the transtheoretical model in a German sample of adolescents. Some of our findings raise questions about the usefulness of five discrete stages. From a public health viewpoint, tailored interventions based on motivational readiness to change would be fruitful, but further research is warranted.